(12/17/16)- Investigators led by Howard J. Hoffman, the director of epidemiology
and statistics program at the National
Institute on Deafness and Other Communication Disorders concluded that the
prevalence of hearing loss in Americans of working age has declined.

The paper was published in a recent edition of the journal JAMA Otolaryangology. The study compared data collected between
1999 and 2004 with data from 2011 and 2012, the most recent available.

Hearing loss in this study was determined to mean if a person could not
hear, in at least one ear, a sound about as loud as rustling leaves. While
15.9% of the population studied in the earlier period had a hearing loss, that
number dropped to 14.1% of the individuals studied in the more recent
timeframe.

The total number of people with a hearing loss fell to 28 million from 27.7
million in the earlier study.

(8/12/01)- In audiological circles, when the term "expectations" is
used it usually refers to the expectations that consumers have regarding the
performance of hearing aids. These expectations can differ considerably. Some
people have an exalted, and completely unrealistic, idea of how well they'll be
able to hear with hearing aids. After resisting the notion for years, when they
finally do succumb and accept hearing aids they want to hear
"everything" that "everybody" else does. Anything less is a
cause for disappointment. For other people, expectations are too low. With some
"fine-tuning" of the hearing aid's electroacoustic characteristics,
assertive communication strategies, and the judicial use of other types of
hearing assistance technologies, they can be helpe d
to communicate much more effectively than they are. One important role of the
professional audiologist is to assist clients balance their hopes against the
limitations imposed by the nature of their hearing problem. Without realistic
expectations, peopl e may either be sorely
disappointed with their hearing aids or "satisfied" with much less
benefit than what is possible. So consumers' expectations not only have to be
satisfied to a large extent, but they also have to be realistic. If not, the
aids are li kely to be returned or discarded; at the
least, we can predict a very unhappy hearing aid user!

The problem is that there is no way that I know of to determine, in any
objective fashion, exactly what can be considered "realistic" aided
performance targets with hearing aids. Can someone do even better with a different
adjustment, or a different set of hearing aids? While we really don't know the
answer to this (it is not possible to compare every possible combination of
hearing aid and speech processing strategy), some estimate has to be made
whether "expected" targets have been reached. Using their training,
experience, and various audiological tools, audiologists do try to arrive at an
estimate of whether the aided performance of a particular client is sa t isfactory,
i.e. whether their "expectations" have been met. The weakness of this
approach is that the client's role is essentially passive, that of a recipient
of a service and not someone who is really the main
stakeholder in the process. Unfortunately, prospective hearing aid users
usually do not know what they should and should not "expect" from the
audiologist, in terms of service, follow-up appointments, and information.

Expectations, in other words, cut both ways. Not only is it necessary for
audio logists to help people formulate realistic
expectations regarding the hearing aid performance, it is also necessary that
clients know what to expect from their audiologist. In this paper, I will
outline the information and services that I think that new hearing aid users
should expect from their audiologists. I emphasize that this is my personal
list, based on my personal judgement, though it is one that I would gladly
debate with those who may disagree with its scope and details.

A. At the first visit

1. Did you learn if you are or are not a hearing aid candidate? Based on
what information?

2. Was the nature of your hearing loss explained to you? Did it include:

a. The implications of your audiogram, particularly regarding understanding
speech in noise and why, sometimes, you can "hear", but not
"understand".

b. General amplification goals, and how they relate to your specific
audiogram, loudness sensitivity (recruitment), and your personal communication
needs.

3. Were you administered some sort of self-report scale regarding the effect
of the hearing loss on your life (social, emotional, vocational, etc.)?

a. Did some "significant other" (spouse, adult children) have an
opportunity to complete a parallel form?

b. Did you have an opportunity to talk about the implications of the
specific ratings?.

c. Will you be completing a follow-up scale after you've worn the aids for
several weeks or months?

4. Were the advantages, disadvantages, and function of various hearing aid
options explained to you?

5. Were changes in any of the electroacoustic parameters explained to you?

D. Group Hearing Aid Orientation Program. This is a highly recommended
service that should be incorporated into the hearing aid selection process, at no extra charge. It serves to
reinforce and extend information covered in individual sessions, plus it gives
an opportunity for valuable group interactions. The following is a general
outline of the content of such a program.

4. Presentation and discussion of other types of hearing assistance
technologies (e.g. TV devices, aids to telephone communication, large-area
assistive listening devices, personal FM systems, and signalling
and warning d evices of all kinds). The need for such
devices determined in respect to social and vocational implications. How such
systems can be purchased.

1. You can decide, within 30 days, whether the cost/benefit ratio of the
aids is sufficiently positive to justify purchase. But be realistic.

2. Finally, don't hesitate to call your audiologist if you have questions or
problems (many of these would have been answered or managed if you participated
in the group hearing aid orientation program). They can't do their job appropriately
unless you give them constructive feedback.